FDA warning

This
drug has a Black Box Warning. This is the most serious warning from the Food
and Drug Administration (FDA). A black box warning alerts doctors and patients
to potentially dangerous effects.

Severe skin reaction warning. This drug may cause
life-threatening allergic reactions called Stevens-Johnson syndrome (SJS) and
toxic epidermal necrolysis (TEN). These may cause severe damage to your skin
and internal organs. Your risk may be higher if you have an Asian ancestry with
a genetic risk factor. If you’re Asian, your doctor may test you for this
genetic factor. You can still develop these conditions without the genetic risk
factor. Call your doctor right away if you have any of these symptoms:

skin rash

hives

swelling of your tongue, lips, or face

blisters on your skin or the mucous
membranes of your mouth, nose, eyes, or genitals

Low blood cell count warning. This drug may decrease the number of
blood cells your body makes. In rare cases, this can cause serious or
life-threatening health problems. Tell your doctor if you’ve ever had low blood
cells, especially if it was caused by another drug. Call your doctor right away
if you have any of these symptoms:

sore throat, fever, or other infections
that come and go or don’t go away

bruising more easily than normal

red or purple spots on your body

bleeding from your gums or nosebleeds

intense fatigue or weakness

Risk of suicide

This drug may cause
suicidal thoughts or actions in a small number of people, about 1 in 500. Call
your doctor right away if you have any of these symptoms:

thoughts about suicide or dying

attempts to commit suicide

new or worse depression

new or worse anxiety

feeling agitated or restless

panic attacks

trouble sleeping

new or worse irritability

acting aggressive or violent or being
angry

acting on dangerous impulses

an extreme increase in activity or
talking

other unusual behavior or mood changes

Heart problems

This drug may
cause an irregular heart rate. Symptoms include:

fast, slow, or pounding heart rate

shortness of breath

feeling lightheaded

fainting

Liver problems

This drug may raise
your risk of live problems. Symptoms include:

yellowing of your skin or the whites of
your eyes

dark-colored urine

pain on the right side of your stomach

bruising more easily than normal

loss of appetite

nausea or vomiting

What is carbamazepine?

Carbamazepine is used
to treat trigeminal neuralgia and certain types of seizures caused by epilepsy. These seizures
include:

partial seizures

generalized tonic-clonic (grand mal) seizures

mixed seizure patterns, which include the seizure
types listed here or other partial or generalized seizures

Carbamazepine is not used to treat absence (petit
mal) seizures.

Why it's used

This drug belongs to a class of drugs called
anticonvulsants. A class of drugs refers to medications that work similarly.
They have a similar chemical structure and are often used to treat similar
conditions.

How it works

It is not completely known how this drug treats bipolar disorder, epilepsy, or trigeminal nerve pain. It is known to block sodium currents in your brain and body. This helps to reduce abnormal electrical activity between your nerve cells.

Why it's used

This drug belongs to a class of drugs called
anticonvulsants. A class of drugs refers to medications that work similarly.
They have a similar chemical structure and are often used to treat similar
conditions.

This drug is used to treat episodes of mania (frenzied,
abnormally excited, or irritated mood) or mixed episodes (symptoms of mania and
depression that happen at the same time) in people with bipolar disorder.

This drug is also used to control certain
types of seizures in people with epilepsy, and to treat trigeminal neuralgia, a
condition that causes facial nerve pain.

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SECTION 2 of 4

carbamazepine Side Effects

Oral tablet

Most Common Side Effects

The most common side effects
that occur with carbamazepine include:

stomach problems,
including:

nausea

vomiting

problems with walking and coordination

dizziness

drowsiness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

Severe skin reaction. Symptoms include:

skin
rash

hives

swelling
of your tongue, lips, or face

blisters
on your skin or the mucous membranes of your mouth, nose, eyes, or genitals

Low blood cell counts. Symptoms
include:

sore
throat, fever, or other infections that come and go or don’t go away

Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug may cause drowsiness.

Disclaimer:
Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

SECTION 3 of 4

carbamazepine May Interact with Other Medications

Oral tablet

Carbamazepine can
interact with other medications, herbs, or vitamins you might be taking. That’s
why your doctor should manage all of your medications carefully. If you’re
curious about how this drug might interact with something else you’re taking,
talk to your doctor or pharmacist.

Note: You can reduce your
chances of drug interactions by having all of your prescriptions filled at the
same pharmacy. That way, a pharmacist can check for possible drug interactions.

Food interactions

Grapefruit juice blocks the enzyme that breaks down carbamazepine. Drinking grapefruit juice while taking this drug can cause higher levels of the drug in your body. This raises your risk of side effects.

Alcohol interaction

Medications that might interact with this drug

Heart drugs

diltiazem

verapamil

Taking one of these drugs with carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your doctor may monitor your blood levels of carbamazepine if you’re taking it with one of these drugs.

Fungal infection drugs

ketoconazole

itraconazole

fluconazole

voriconazole

Taking one of these drugs with carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your doctor may monitor your blood levels of carbamazepine if you’re taking it with one of these drugs.

Altitude sickness drug

acetazolamide

Taking this drug with
carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with this drug.

Anti-allergy drug

loratadine

Taking this drug with
carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with this drug.

Antibiotics

clarithromycin

erythromycin

telithromycin

chloramphenicol

rifampin

rifabutin

rifapentine

Taking one of these drugs with carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your doctor may monitor your blood levels of carbamazepine if you’re taking it with one of these drugs.

ritonavir

indinavir

nelfinavir

saquinavir

Taking one of these
drugs with carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with one of these drugs.

Tuberculosis drug

rifampin

Taking this drug with
carbamazepine will decrease the level of carbamazepine in your body. This means that it won’t work as
well to treat your condition. Your doctor may monitor your blood levels of
carbamazepine if you’re taking it with this drug.

Anti-nausea drugs

aprepitant

Taking this drug with
carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with this drug.

Anti-depression drugs

fluoxetine

fluvoxamine

trazodone

olanzapine

Taking one of these
drugs with carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with one of these drugs.

nefazodone

Taking this drug with
carbamazepine will decrease the level of nefazodone in your
body. Your doctor may monitor your blood levels of nefazodone and change your
dosage of that drug.

Anti-spasm drug

dantrolene

Taking this drug with
carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with this drug.

Bladder drug

oxybutynin

Taking this drug with
carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with this drug.

Blood thinner

ticlopidine

Taking this drug with
carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with this drug.

Heartburn drugs

cimetidine

omeprazole

Taking one of these
drugs with carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with one of these drugs.

HIV drugs

ritonavir

indinavir

nelfinavir

saquinavir

Taking one of these
drugs with carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with one of these drugs.

Anti-seizure drugs

felbamate

methsuximide

phenytoin

fosphenytoin

phenobarbital

primidone

Taking one of these
drugs with carbamazepine will decrease the level of carbamazepine in your body. This means it won’t work as well to treat your condition.
Your doctor may monitor your
blood levels of carbamazepine.

valproic acid

Taking this drug with
carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with this drug.

phenytoin

phenobarbital

Taking carbamazepine
with one of these drugs may affect how your thyroid hormone works.

Herbal products

niacinamide

Taking this drug with
carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with this drug.

Cancer drugs

cisplatin

doxorubicin

Taking one of these
drugs with carbamazepine will decrease the level of carbamazepine in your body. This means it won’t work as well to
treat your condition. Your doctor may monitor your blood levels of carbamazepine if you’re taking it with one of these drugs.

temsirolimus

lapatinib

Taking one of these
drugs with carbamazepine will decrease the level of the cancer drug in your
body. Your doctor may monitor your blood levels of that cancer drug and change
your dosage of that drug.

cyclophosphamide

Taking this drug with
carbamazepine will increase the level of the cancer drug in your
body. Your doctor may monitor your blood levels of that cancer drug and change
your dosage of that drug.

Pain drugs

ibuprofen

Taking this drug with
carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with this drug.

Psychiatry drugs

loxapine

olanzapine

quetiapine

Taking one of these
drugs with carbamazepine will increase the level of carbamazepine in your body. This can cause side effects. Your
doctor may monitor your blood levels of carbamazepine if you’re taking it with one of these drugs.

aripiprazole

Taking this drug with
carbamazepine will decrease the levels of aripiprazole in your
body.

Anti-rejection drugs

tacrolimus

Taking this drug with
carbamazepine will decrease the levels of carbamazepine in your body. Your
doctor may monitor your blood levels of carbamazepine and change your dosage of
that drug.

Bipolar disorder drugs

lithium

Taking this drug with
carbamazepine may increase your risk of side effects.

Tuberculosis drugs

isoniazid

Taking this drug with
carbamazepine may increase your risk of liver damage.

Hormonal birth control drugs

Taking carbamazepine with
hormonal birth control may make the birth control less effective. You may need
to use alternative or back-up methods of contraception.

Respiratory drugs

aminophylline

theophylline

Taking one of these
drugs with carbamazepine will make that respiratory drug less effective. This
is because carbamazepine makes the body process the drug more quickly, which
decreases the amount of it in your blood.

Muscle relaxers

pancuronium

vecuronium

rocuronium

cisatracurium

Taking one of these
drugs with carbamazepine can decrease the effect of these medications. Your
doctor may adjust the dose of these drugs.

Disclaimer:
Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Drug warnings

People with liver disease

This drug is not recommended for use with acute (severe) liver disease as it may make the condition worse. If you have stable liver disease, your doctor will monitor and adjust your dose. If your liver disease suddenly gets worse, call your doctor to discuss your dose and use of this drug.

People with heart disease

If you have any damage to your heart or an abnormal heart rhythm, this drug may make it worse.

Pregnant women

This drug is a category D
pregnancy drug. That means two things:

Studies show a risk of adverse effects to the
fetus when the mother takes the drug.

The benefits of taking the drug during pregnancy
may outweigh the potential risks in certain cases.

Tell your doctor if you’re pregnant or plan to become pregnant. This drug
should be used during pregnancy only if the potential benefit justifies the
potential risk to the fetus.

Women who are breast-feeding

This drug passes into breastmilk. It may cause serious
effects in a child who is breastfed.

You and your doctor may need to decide if you’ll
take this drug or breastfeed.

For seniors

Older adults may
process this drug more slowly. Because of this, your doctor should monitor you
more closely while you’re taking this drug.

For children

The safety and
effectiveness of this drug for bipolar disorder and trigeminal neuralgia
hasn’t been established in people younger than 18 years.

Allergies

This drug may cause a severe allergic reaction. Symptoms include:

trouble breathing

swelling of your throat or tongue

hives or rash

blistering or peeling skin

Don’t take this drug again
if you’ve ever had an allergic reaction to it before.
Taking it a second time after an allergic reaction could be fatal.

SECTION 4 of 4

How to Take carbamazepine (Dosage)

Oral tablet

All possible dosages
and forms may not be included here. Your dose, form, and how often you take it
will depend on:

your age

the condition being treated

how severe your condition is

other medical conditions you have

how you react to the first dose

What are you taking this medication for?

Bipolar disorder

Brand: Equetro

Form: oral capsule (extended release)

Strengths: 100 mg, 200 mg, 300 mg

Adult dosage (ages 18 years and older)

First
dose: 200 mg taken by mouth 2 times per day

Dose changes: Your doctor may increase your dose by 200 mg per day.

Child dosage (ages 0-17 years)

None given. The safety and effectiveness of carbamazepine hasn’t been established in people younger than 18 years.

Senior dosage (ages 65 years and older)

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Epilepsy

Brand: Tegretol/Tegretol XR

Form: Oral tablet

Strengths: 100 mg (chewable), 200 mg

Form: Oral tablet (extended release)

Strengths: 100 mg, 200 mg, 400 mg

Form: Oral suspension

Strengths: 100 mg/5 mL

Brand: Carbatrol

Form: Oral tablet (extended release)

Strengths: 100 mg, 200 mg, 300 mg

Brand: Epitol

Form: Oral tablet

Strengths: 200 mg

Adult dosage (ages 18 years and older)

First dose:

Tablets, extended-release tablets, and
capsules: 200 mg taken by mouth 2 times per day

Oral suspension: 5 mL taken by mouth 4 times per day (400 mg total per day)

Oral solution: 2.5 mL taken by mouth 4 timers per
day (200 mg per day)

Usual dose: 400–800
mg per day

Child dosage (ages 0-5 years)

First dose:

Tablets: 10–20 mg/kg per day. The dosage should be divided and taken by mouth 2–3 times each day.

Oral solution: 10–20 mg/kg per day. The dosage should be divided and taken by mouth 4 times per day.

Dose changes: Your doctor may increase your dose weekly.

Maximum dose: 35 mg/kg per day

Senior dosage (ages 65 years and older)

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Trigeminal nerve pain

Brand: Tegretol/Tegretol XR

Form: Oral tablet

Strengths: 100 mg (chewable), 200 mg

Form: Oral tablet (extended release)

Strengths: 100 mg, 200 mg, 400 mg

Form: Oral suspension

Strengths: 100 mg/5 mL

Brand: Carbatrol

Form: Oral tablet (extended release)

Strengths: 100 mg, 200 mg, 300 mg

Brand: Epitol

Form: Oral tablet

Strengths: 200 mg

Adult dosage (ages 18 years and older)

First
dose:

Tablets and extended release tablets: 100 mg taken by mouth 2 times per day

Maximum
dose: 1,200 mg per day

Child dosage (ages 0-17 years)

None given. The
safety and effectiveness of carbamazepine hasn’t been established in people
younger than 18 years.

Senior dosage (ages 65 years and older)

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Disclaimer:
Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don’t take it as prescribed.

If you skip or miss doses

You may not see a full benefit of this drug for the treatment of your condition. If you double up your dose or take it too close to your next scheduled time, you may have a higher risk of serious side effects.

If you take too much

You may see an increased risk of side effects associated with this medication. If you think you have taken too much of this drug, go to the nearest emergency room.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then only take one dose at your scheduled time.

Never try to catch up by taking two doses at once. This could cause toxic side effects.

If you don’t take it at all

Your bipolar disorder or epilepsy won’t be treated. If you’re taking this drug for trigeminal neuralgia, your facial pain may get worse.

How to tell if the drug is working

Bipolar disorder: You may be able to tell if this drug is working if your symptoms of bipolar disorder get better.

Epilepsy: You may be able to tell if this drug is working if you have fewer seizures.

Trigeminal neuralgia: You may be able to tell if this drug is working if your facial pain gets better.

Taking this drug with food depends on its form

The tablets, oral
suspension, and extended-release tablets should be taken with meals.

The extended-release
capsules can be taken with or without meals.

Follow these guidelines for consuming the tablet

The extended-release tablets shouldn’t
be crushed or chewed.

The extended-release capsules may be
opened and the beads inside the capsule can be sprinkled over food, such as a
teaspoon of applesauce. Then swallow the dose all at once. You should use this
method if you cannot swallow the capsule whole. You shouldn’t crush or chew the
contents of the capsule.

The 100-mg immediate-release tablet can
be chewed.

The 200-mg immediate-release tablet can be
crushed, but should not be chewed.

This drug must be stored at the right temperature

Tablets and oral suspension:

Don’t store this drug above 86°F (30°C).

Keep this drug away
from light.

Keep it away from high
temperature

Keep your drugs away
from areas where they could get wet, such as bathrooms. Store this drug away
from moisture and damp locations.

Extended-release
tablets and extended-release capsules:

Store this drug at
77°F (25°C). It’s OK to store it briefly between 59°F (15°C) and 86°F (30°C).

Keep this drug away
from light.

Keep it away from high
temperature.

Keep your drugs away
from areas where they could get wet, such as bathrooms. Store this drug away
from moisture and damp locations.

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Disclaimer:
Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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